Doctor Summeroff

Doctor Summeroff

Jun 12, 2015

I’ve been thinking about writing this post for a week or so.  It’s a tough decision to make, but I feel that its something that I need to do. I started this blog about five and a half years ago on a whim to see if I could get myself back into writing which is something that I have always enjoyed since childhood.  Now, here I am almost 400 posts later, and still going strong.  Anybody who reads what I write regularly knows that there has been a bit of a slowdown as of late.  That is mainly due to the amount of stuff that I currently have going on in my life outside of the blog.  EMS Compass, a part time job, teaching, my full time job, traveling, a social life.  Most of my “EMS related” time ends up pretty tied up leaving less and less time for writing. As far as internet age goes, five and a half years is pretty old.  Most of the blogs that I pick up and read seem to have a shelf life of six months or less.  People get into writing, put 110% into it and then just grind to a halt mostly due to a lack of material.  Somehow, I pushed through that and found that comfortable balance between having things to write about and posting them in moderation so that I could stay ahead or at least keep up with my posting schedule.  Its not easy to do, and for anybody looking to start a blog that is the biggest tip that I can give you. What it comes down to is I think that it is time for me to take a short break from writing here at EMS in the New Decade.  The blog is not going away by any means.  Instead, I am simply going to take a few months off and start fresh in September.  This will give me time to get reorganized, deal with what is shaping up to be a very busy summer, work on some other side projects, and just do some writing in moderation so that when I do come back in September I have lots...

Nightwatch: A Review

Nightwatch: A Review

Feb 13, 2015

For the last forty years Hollywood and EMS dramas have not mixed.  When it comes to creating a drama that relatively, not even accurately, portrays the daily lives of EMTs and paramedics, many of us in the field have viewed attempt after attempt with high hopes only to walk away disappointed.  Trauma.  Rescue 77.  Even Third Watch.  None of these shows have even remotely captured what my life is like on the truck or off. Reality TV has not done much better.  Paramedics on TLC back in the 2000’s came close however the show was so poorly edited that I don’t think that they had anybody with an EMT card in their back pocket in the cutting room with the power to say “this doesn’t look right.” While I was excited for its premier, I am sure you can understand my reservations when A&E announced their new series Nightwatch which was set to follow the EMS, police, and fire personnel working the 8pm-4am shift in New Orleans, Louisiana.  My interest was piqued after seeing the trailers though.  I was excited to see that Dick Wolf, creator of  Law & Order had a hand in it, and I was even more excited that it was following one of my favorite reality TV shows ever to be on television: The First 48. The EMS/fire ratio One of the first things that struck me about the show was how the cast was introduced in the premier’s first fifteen or twenty minutes.  Two medic units care for a shooting victim as he circles the drain.  The police officers portrayed in the show search for a shooting suspect.  Then we cut to the fire house where the guys of Squirt 27 are debating what they are going to have for dinner.  I chuckled because that’s how it usually goes in urban EMS.  EMS spends their time in mobile offices with fire department units landing back in a station. Please do not take that as a dig at the fire service.  I have a ton of respect for the men and women who do a job that I have zero desire to do, however, as the show progresses through the...

Evolving Education

Evolving Education

Jan 16, 2015

What makes somebody qualified to teach an EMT or paramedic class?  I took my first EMT class back in 1995 at night while I went to high school during the day.  I knew every single one of my instructors either personally, or more likely by reputation.  They were sage-like legends in the field of EMS.  They were the old guard.  And it was their job to educate the young, motivated naive students such as myself. Fast forward to college and it was much of the same.  For the most part, the people who taught my second EMT class and my paramedic class already had twenty to thirty years in the field.  They lived and breathed EMS and would share story after story about what they encountered over the years.  They talked about the first time that they had to tie an ankle hitch because the one provided with the HARE had been lost under the bench seat, and that was why it was so important for me to learn how to do the same. In May of this year, I will celebrate my fifteenth anniversary of getting a paycheck for working on the ambulance but my life in EMS extends a couple of years past that.  I got my start in the back end of what was the successful days of volunteer EMS.  We covered our calls, did not understand what a ROSC rate was, and were happy to get a CPR save pin every year at our department’s installation dinner.  Daytime ambulances were staffed by mothers who put their kids on the school bus and then turned the pager on, people who worked nights, or some of those legendary EMS providers who taught at night and were otherwise retired.  They donated their time which is something that does not happen very often anymore for a number of reasons some of them cultural, and others financial.  Any way you cut it though, volunteerism in EMS is all but done in most of the country. So here we sit now, half way through this decade, and we need to figure out who takes the reins.  Many of those EMS legends are in the twilight of...

Ebola Awareness Part 3: EMS Response

Ebola Awareness Part 3: EMS Response

Oct 22, 2014

In the first part of this series, we took a look at the disease of Ebola itself.  In the second installment we looked at the disease’s signs and symptoms, and took at look at how we as prehospital providers could be put at risk.  In this final part we take a look at the role EMS will be paying in the battle against Ebola. The EMS Response to Ebola In a recent EMS1 article, Dr. Alex Garza took a look at Ebola and how it will affect EMS responders.  One of the first things that he pointed out was the need for specialized air ambulances to transport these patients.  Personally, I feel that we need specialized responders as well.  Dealing with highly infectious diseases such as Ebola requires specialized training and treatment for the patients.  The infection control training that EMTs and paramedics receive is usually focused on “universal precautions and Body Substance Isolation” heck, if you don’t say that at the start of every National Registry station, you’re most likely going to have to retest, but I digress. . . Much like we have specialized HazMat technicians in many systems, and SWAT medics maybe we need specially trained medics and EMTs to handle specifically the interfacility transport of potentially contagious patients. I also spend a lot of time reading the National EMS Management Association (NEMSMA) ListServ on Google.  There has been a lot of talk over the past couple of weeks about different services developing policies and procedures for dealing with patients who possibly have contracted Ebola.  If your department releases anything, read it.  Memorize it.  Make sure you know what your point of entry plan is.  Is one hospital being designated as an Ebola receiving facility?  Who do you have to notify if you have a possibly infected patient?  Are there any radio codes that you need to be aware of?  Also do not be afraid to ask your leadership for answers to any of these questions.  If they don’t have them, suggest that they might be important.  If they’re resistant go higher up the chain if you have to, or at least as high as you are comfortable going. The Center...

Ebola Awareness Part 2: What You Need to Know

Ebola Awareness Part 2: What You Need to Know

Oct 21, 2014

In the first of this three part series about the Ebola virus, we talked about the history of the disease, and a little about the pathophysiology of it.  Now that we have a little background about it, let’s look at its signs, symptoms, and talk a little about the treatment of Ebola. How Does a Person Catch Ebola? As we touched on in part 1, Ebola is transmitted through direct contact with body fluids of a living or deceased infected person or animal.  The list of fluids that traces of the Ebola virus have been found in it not a surprising one, and includes saliva, mucus, vomit, sweat, tears, breast milk, urine, feces, and semen.  According to the Center for Disease Control and Prevention (CDC) the virus can live in body fluids for “several days” at room temperature, which brings up some serious conundrums when it comes to the pronouncement of patients with obvious signs of death that are encountered in the field. This is why we need to stress the importance of universal precautions with every single patient that we encounter.  The CDC tells us that transmission occurs through “direct contact” with bodily fluids.  Direct contact means that “body fluids from an infected person have touched someone’s eyes, nose, or mouth or an open cut, wound, or abrasion.”  While alarming, contact of body fluids with unbroken skin is at a very low risk for transmission of the disease. The big concern right now that is being fueled by the mainstream media is the prospect of the Ebola virus becoming airborne.  While it is known that it has not currently taken on that characteristic, as previously stated, traces of the virus has been found in saliva and mucus.  While coughing and sneezing are not a commonly found with Ebola patients, should a patient with Ebola cough in the face of another individual, there is a risk that the disease could be transmitted. What are the Symptoms? Now that we know how the disease is transmitted, how can we tell if somebody has it?  The alarming thing about Ebola is the symptoms that you will see in patients infected with the virus are quite familiar:...

Ebola Awareness Part 1: History and Facts

Ebola Awareness Part 1: History and Facts

Oct 20, 2014

In light of all of the media attention being made about the most recent Ebola outbreak that has now spread to the United States, I thought it would be beneficial to put together a three part series about the Ebola Virus.  In this first part, we will talk about the history of the disease to help us better understand where it came from, and the impact that it has had over the past nearly forty years.  Part two will talk about what you as an EMS responder needs to know about the disease, and in the final part we will talk about things that you should think about after dealing with a potentially infected patient. The Discovery of Ebola Ebola was discovered after its first documented outbreak in 1976 which occurred from June through November in Nzara, South Sudan.  The World Health Organization (WHO) knew that they were dealing with some sort of hemmoragic fever but did not realize that it would be as deadly as the Ebola virus turned out to be. The first documented case of Ebola was discovered on June 27th when a Sudanese store owner became symptomatic and died just nine days later.  In total, the first outbreak of Ebola infected 284 people and resulted in 151 deaths. The disease was named nearly six months later for the Ebola River which is located near the location of the first documented outbreak.  With the disease becoming more publicized thanks to the WHO and Center for Disease Control and Prevention’s (CDC) involvement, an additional 318 cases were identified with 280 of them proving to be fatal.  The two departments undertook a combined effort to contain the disease and were eventually successful in doing so.  Interestingly enough, one of the most effective strategies that was used to contain the outbreak was the advocating of the discontinuation of reusing needles by local medical providers. Over the next nearly twenty years the disease stayed out of the headlines and off the radar of the CDC and WHO then in 1995, the second major outbreak of Ebola occurred in Congo infecting 315 people and killing 254.  Five years later, another outbreak occurred in Uganda claiming an...

The Best in the Country

The Best in the Country

Aug 17, 2014

Every year, American Medical Response holds a nationwide skills competition amongst their divisions.  Tryouts are held regionally and eventually the top six divisions in the country who scored the highest in the preliminary competition are sent to Colorado to compete for the right to brag that they are the best in the country.  For the second year in a row, the Springfield, Massachusetts division is represented in the finals.  Last year, it was a pair of paramedics Erin Markt and Kim Arnone who represented my old stomping grounds.  This year it is a pair of paramedics Nick Chirekos an Roy Rudolph who will be representing Western Massachusetts. The event is held in a large “simulated” city where a crew is given a fully stocked ambulance and asked to respond to calls in this mock setting where they are heavily monitored and thrown curve balls around every corner.  The stories that Kim and Erin told me last year were great.  It sounds like such a fun experience, and each of them took something from the competition. First of all, I want to to say how great it is to see AMR holding an event like this.  As the largest ambulance company in the United States, it rests on their shoulders to also strive for clinical excellence.  Putting their divisions in the spotlight like this is a great way to showcase just how good the company has become clinically.  While I am not surprised to see Springfield heading to the finals yet again, I feel like it is something that deserves quite a lot of attention. With the brewing turf war in Holyoke, Massachusetts with their fire department, and past investigative “reporting” on the division’s performance in Springfield that revolved around response times this is yet another example of how great the clinical care being provided in the greater Springfield area really is.  While some will complain about AMR as a corporation and their motives in the medical field which are occasionally driven by their need to be a profitable company for the stakeholder’s sake, the motive for the street personnel has and always will be to deliver the best patient care that they are capable...

Podcast Episode 2: Sirens on the USA Network!

Podcast Episode 2: Sirens on the USA Network!

May 7, 2014

While the initial plan was to post my podcasts on Mondays, this one was too good to pass up on posting a little early.  In this episode, I talk with Kevin Bigley and Kevin Daniels who play Brian and Hank respectively on USA’s new comedy series Sirens.  I have been a supporter of this project from the start.  Personally, I think it is hilarious.  If you have not watched it yet, you really need to. I had a great time talking to both Kevin Bigley and Kevin Daniels.  Hopefully you enjoy listening to the podcast as much as I enjoyed recording it! To download the podcast, click this link!  Otherwise, use the player below. Share...

EMS in the New Decade: The Podcast!

EMS in the New Decade: The Podcast!

Apr 30, 2014

Yes, you read that title right: The Podcast.  The time has come for me to finally do what I have wanted to do for a couple years now.  On Monday May 5, I will release the first episode of my podcast carrying the same title as this blog.  This is something that I have wanted to do for a long, long time, and have been asked to do by a few people but I never really felt that I had the time. A lot of the roadblocks that I had keeping me from doing this are not there anymore, and it is time for me to take the plunge.  Monday’s show will be an overview of what to expect from the episodes to come.  Shows will be posted weekly on Monday mornings at 10:30am EST, and will be listed along with my other blog posts on the homepage of my blog.  In addition to that, there will be a link in the menu to take you to the index of all of my podcast episodes.  Also, I am currently creating an index of past episodes of other shows that I have been part of.  They will be part of this menu page as well. It feels really good to be back writing at 100%.  The major life change, and employer change took its toll on me for a while.  It is not easy to start over in a new system with new people, new protocols, and new everything.  I was ripped from my comfort zone, and it took me a while to get back close to it.  I’m not there yet, and there’s challenges that I am dealing with every day, but to be back writing is an important part of that for me.  It just seems like the next logical step for me is to get back into podcasting, and even more logical to finally host my own show. I really cannot tell you how excited I am about this.  Thanks to the support of people like Ben Neal, RJ Stine, Random Ward, Natalie Quebodeaux, and of course Kyle David Bates, Chris Montera and Jamie Davis, I am finally going to make it...

Preparation and Response

Preparation and Response

Apr 16, 2013

First of all I want to send out thoughts and prayers to everyone involved in yesterday’s explosion at the Boston Marathon.  It is a shame that we live in a world where we even have to deal with these incredibly tragic events, however, they also show the resilience of the American people.  We will recover, and we will overcome. In the wake of yesterday’s tragedy one thing I think everyone needs to realize is how lucky Boston is to have the men and women of Boston EMS caring for the people of their city.  In the days leading up to the Marathon, the Boston EMS Twitter was extremely active talking about the immense amount of preparation leading up to Monday morning.  From the looks of it they were ready for almost anything.  And kudos to Boston EMS for sharing that fact with the world. If nothing else, those of us in the EMS community need to walk away from this with recognition of how important preplanning is.  None of us should ever take for granted our own personal safety or the safety of any event that we cover.  No one should ever utter the words, “that will never happen here.”  Instead, take the extra time to draw up a detailed plan.  Know your staging areas, know your egress routes, and make sure that every single provider involved is aware of them as well. Another thing that needs to be pointed out that I think many people not involved in public safety lose sight of rather quickly is while this large response was going on in Copley Square the rest of Boston was still calling 9-1-1.  Boston EMS, Fire, and Police were just as busy as they were on Sunday, and just as busy as they will be today.  In my eyes, that is one of the most remarkable things about incidents like this.  Not only does the public safety community step up to deal with a major crisis at hand, they also continue to handle those routine emergencies that so frequently flood communities. While watching the news, I saw a number of different ambulances down at that scene: Cataldo, Lifeline, McCabe, AMR, and Professional...